Videoconferencing psychotherapy (VCP)-the remote delivery of psychotherapy via secure video link-is an innovative way of delivering psychotherapy, which has the potential to overcome many of the regularly cited barriers to accessing psychological treatment. However, some debate exists as to whether an adequate working alliance can be formed between therapist and client, when therapy is delivered through such a medium. The presented article is a systematic literature review and two meta-analyses aimed at answering the questions: Is working alliance actually poorer in VCP? And is outcome equivalence possible between VCP and face-to-face delivery? Twelve studies were identified which met inclusion/exclusion criteria, all of which demonstrated good working alliance and outcome for VCP. Meta-analyses showed that working alliance in VCP was inferior to face-to-face delivery (standardized mean difference [SMD] = -0.30; 95% confidence interval [CI] [-0.67, 0.07], p = 0.11; with the lower bound of the CI extending beyond the noninferiority margin [-0.50]), but that target symptom reduction was noninferior (SMD = -0.03; 95% CI [-0.45, 0.40], p = 0.90; CI within the noninferiority margin [0.50]). These results are discussed and directions for future research recommended.
Objectives and Design: Debate exists as to patient experience, and the importance, of the working alliance (WA) in videoconferencing psychotherapy (VCP). This study used a two-phase explanatory sequential design to investigate the WA as a change process in VCP.Methods: Phase I: sessional VCP outcome and WA data were analysed using multilevel modelling (n = 46). Phase II: participants (n = 12) from Phase I were recruited to semi-structured interviews, analysed using thematic framework analysis. Results and Conclusions: Results demonstrate: (1) a significant correlation between WA and outcome (F(1, 15.19) = 25.01, p < 0.001), (2) previous session WA significantly predicted outcome in the next session (F(1, 355.61) = 4.47, p < 0.05), and (3) previous session outcome significantly predicted next session WA (F(1, 55.3) = 15.19, p < 0.001), with three core themes explaining patient experience (engaging with the medium, connection with the therapist, and working via
Purpose The involvement of service users within clinical psychology training is written into policy. However, the practice of evaluating involvement from both trainees’ and service users’ viewpoint is minimal. The purpose of this paper is to evaluate recent service user involvement in psychometrics and formulation teaching on a clinical psychology training programme, from both service user and trainee perspectives. Design/methodology/approach Focus groups were held with service users (n=3) involved in the teaching, as well as trainees (n=3). Additional questionnaire data were captured from trainees (n=11). Service user and trainee data were analysed separately using thematic analysis. Themes generated for trainees were also mapped on to a competency framework for clinical psychologists. Findings Both parties found the teaching beneficial. Service users enjoyed supporting trainees and engaged positively in their roles. They identified relational aspects and reflections on their own therapy as other benefits. Trainees reported enhanced clinical preparedness, critical and personal reflection. Trainee anxiety was evident. Learning mapped well to competency frameworks. Research limitations/implications The samples were small and some data truncated. Findings speak to broader issues and may transfer to other involvement contexts. Practical implications A good degree of meaningful involvement can be achieved through such initiatives, to mutual benefit and enhanced learning. Originality/value Nature of the exercise and dual-aspect approach to evaluation described here helps to minimise tokenism. The mapping of findings to competency frameworks supports evaluative processes and helps to legitimise involvement initiatives that challenge the boundaries of existing practice.
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